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目的探讨同型半胱氨酸(Hcy)与重症肝炎的关系。方法用全自动生化分析仪测定35例重症肝炎患者血清 Hcy 水平,同时检测血清总胆红素(TBIL)、丙氨酸转氨酶(ALT)、门冬氨酸转氨酶(AST)、线粒体型门冬氨酸转氨酶(m-AST)、胆碱酯酶(CHE)、前白蛋白(PALB)、葡萄糖(GLU)、胆固醇(CHO)、肌酐(CREA)活性与含量,观察 Hcy 变化及与各生化指标变化的相关性。结果重症肝炎患者血清 Hcy 水平明显升高[(24.0±5.4)μmol/L],与正常对照[(7.8±3.0)μmol/L]相比差异有统计学意义(t=14.603,P<0.01),异常检出率100%。重症肝炎糖脂降低组 Hcy 水平[(24.6±4.2)μmol/L]比糖脂正常组[(17.4±1.9)μmol/L]明显增高(t=5.414 3,P<0.01)。其变化与TBIL、AST、m-AST 正相关(r=0.4502,0.3980,0.4453),与 CHE、PALB、CHO、GLU 负相关(r=-0.1545,-0.2946,-0.1053,-0.2260),尤其与 TBIL、m-AST 有显著相关性(P<0.05),与ALT 无明显相关性(r=0.0925,P>0.05)。结论高 Hcy 血症可能是重症肝炎的一个危险因素,且与重症肝炎互为因果关系。Hcy 可作为重症肝炎诊断和病情检测的新的生化指标。
Objective To investigate the relationship between homocysteine (Hcy) and severe hepatitis. Methods Serum levels of Hcy in 35 patients with severe hepatitis were measured by automatic biochemical analyzer. Serum levels of total bilirubin (TBIL), alanine aminotransferase (ALT), aspartate aminotransferase (AST), mitochondrial aspartate The activity and content of m-AST, CHE, PALB, GLU, CHO and CREA were observed and the changes of Hcy and the changes of the biochemical indexes Relevance. Results Serum Hcy levels were significantly higher in patients with severe hepatitis [(24.0 ± 5.4) μmol / L] compared with those in normal controls [(7.8 ± 3.0) μmol / L] (t = 14.603, P <0.01) , Anomaly detection rate of 100%. The level of Hcy in severe hepatitis with glycolipid reduction [(24.6 ± 4.2) μmol / L] was significantly higher than that in normal group with glycolipid (17.4 ± 1.9) μmol / L (t = 5.414 3, P <0.01). The changes were positively correlated with TBIL, AST and m-AST (r = 0.4502,0.3980,0.4453) and negatively correlated with CHE, PALB, CHO and GLU (r = -0.1545, -0.2946, -0.1053, -0.2260) TBIL and m-AST (P <0.05), but no significant correlation with ALT (r = 0.0925, P> 0.05). Conclusions Hyperhomocysteinemia may be a risk factor for severe hepatitis and causative relationship with severe hepatitis. Hcy can be used as a new biochemical indicator of severe hepatitis diagnosis and disease detection.